Fatty Liver

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A fatty liver is the result of the excess fat in liver cells. Fatty tissue slowly builds up in the liver when a person’s diet exceeds the amount of fat his or her body can handle. A person has a fatty liver when fat makes up at least 5% of the liver 1. Simple fatty liver can be a completely benign condition and usually does not lead to liver damage. However, once there is a buildup of simple fat, the liver becomes vulnerable to further injury, which may result in inflammation and scarring of the liver.
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NAFLD is a progressive complex of liver disease which starts with fat accumulation in the liver without excessive alcohol consumption. It is strongly associated with metabolic syndrome (obesity + insulin resistance + dyslipidemia).
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Excess abdominal fat is associated with fatty liver disease and other health risks such as diabetes9. Waist measurements - which differ according to gender - are used to identify the health risks associated with excess abdominal fat: For men, health risks increase if your waist circumference is more than 102 cm (40 in.). For women, the risks increase if your waist circumference is more than 88 cm (35 in.).
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Fat from a person’s diet is usually metabolized by the liver and other tissues. If the amount of fat exceeds what is required by the body, fat is stored in the fatty tissue. Other reasons for accumulation of fat in the liver could be the transfer of fat from other parts of the body or the inability of the liver to change it into a form that can be eliminated.
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These liver disorders are generally chronic but progressive. Simple presence of fat is what happens with the majority of patients with NAFLD, and most of them have a benign clinical course. However, if let untreated, NAFLD may progress to more advanced disease, such as Non-alcoholic steatohepatitis (NASH), which may evolve to fibrosis, cirrhosis, and liver cancer (HCC) in a few cases.
The disease progression usually takes decades, and depends on a combination of genetic and environmental factors. The relative importance of these factors is variable in different groups and depends of lifestyle choices and other factors such as the intestinal micro-biome (gut microbial community). The components related to the progression of the disease require further studies.
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NASH stands for Non-Alcoholic steatohepatitis and it represents the more severe end of the spectrum of non-alcoholic fatty liver disease. Steatohepatitis means fatty liver with inflammation, in other words, ongoing damage similar to alcoholic liver disease but in this case it occurs in people who do not drink alcohol or drink minimally.
NASH differs from the simple accumulation of fat in the liver, which is a completely benign condition. Up to 20% of adults with NASH develop cirrhosis and up to 11% may experience liver-related deaths. Many individuals develop chronic liver failure and require liver transplantation. The prevalence of NASH is 2-6% in the general population.
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In general, people with fatty liver disease have no symptoms. However, some people report discomfort in the abdomen at the level of the liver, fatigue, a general feeling of being unwell and vague discomfort.
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The liver is involved in approximately 1/3 of all cancers and often those that begin in the gastrointestinal tract, colon, pancreas, stomach, breast and lung. The risk factors involved in this type of liver cancer are numerous given that the cancers originate elsewhere. The prognosis for patients with secondary liver tumors depends on the primary site of malignancy. In general, patients do not live longer than one year from the diagnosis of hepatic metastases. Treatments remain unsatisfactory but include chemotherapy, immunotherapy, and embolization.
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Fatty liver disease is usually suspected in patients who have abnormal liver tests (ALT, AST, GGT) or have an enlarged liver 18. An ultrasound of the liver can suggest the presence of a fatty liver. Other diagnose methods may be used such as computed tomography (CT), proton magnetic resonance spectroscopy (H-MRS), and magnetic resonance imaging (MRI). In some cases, your doctor may advise a liver biopsy, a procedure where the physician inserts a needle into the liver and extracts a sample tissue, which is then examined under a microscope.
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This website provides useful information but is not a substitute for professional medical advice, diagnosis or treatment. Before acting on any of the information in Centre for Liver Diseases, consult with your doctor to make sure that it is right for you.